Akademik Veri Yönetim Sistemi
Türk Alman Jinekoloji Kongresi, Antalya, Türkiye, 23 - 27 Nisan 2025, cilt.1, sa.1, ss.157, (Tam Metin Bildiri)
Triple Vertical Suturing for the Management of Uterine Atony
in a Severe Preeclampsia Patient Receiving Magnesium Sulfate
Can Dinç, Ömer Faruk Öz
Akdeniz University, Faculty of Medicine
Postpartum hemorrhage remains the leading cause of maternal
morbidity and mortality. Although various treatment options are available, some
may pose a risk to future fertility. Nonsurgical interventions for the
reduction and control of bleeding due to uterine atony are applied in a rapid
sequence until hemostasis is achieved. All patients with uterine atony undergo
uterine massage, manual compression, administration of uterotonic agents, and
tranexamic acid. If these measures fail to control bleeding and the patient
remains hemodynamically stable, uterine compression sutures can be applied. These
sutures have been shown to effectively reduce uterine blood loss related to
atony, and various techniques have been described in the literature. Among
these, triple vertical uterine compression sutures represent a novel approach
for managing uterine atony.
In patients with severe preeclampsia, intrapartum and
postpartum seizure prophylaxis with magnesium sulfate is routinely administered
based on evidence from randomized trials demonstrating a significant reduction
in the risk of eclampsia. While some reviews suggest that magnesium sulfate is
not associated with an increased risk of atonic postpartum hemorrhage, data on
this relationship remain inconclusive.
In this case report, we describe a patient with severe
preeclampsia who was receiving magnesium sulfate prophylaxis and developed
uterine atony during a cesarean section. To manage the bleeding, we
successfully applied triple vertical uterine compression sutures.
Keywords: Three vertical compression sutures, Uterine atony,
Magnesium sulfate prophylaxis